Individual provider Active NPI

Katie Pounds Clark, PTA

  • Physical Therapy Assistant
  • Memphis, TN
National Provider Identifier
1124442579
Registry record updated Oct 31, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy AssistantTaxonomy code 225200000X
License
PTA5414 Issued in MS
Practice address
4515 Poplar Ave Ste 210
Memphis, TN 38117-7506
Phone
(901) 728-6912
Fax
(901) 701-2428
NPI assigned
Feb 5, 2014
Last updated
Oct 31, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 31, 2026

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapy Assistant 225200000X PTA5414 MS Primary
Athletic Trainer 2255A2300X 2000015468 MS

Addresses

Primary practice location

4515 Poplar Ave Ste 210
Memphis, TN 38117-7506

Mailing address

4515 Poplar Ave Ste 210
Memphis, TN 38117-7506
Phone (901) 728-6912

Other practice location 1

109 Eureka St
Suite A
Batesville, MS 38606-2534
Phone (662) 578-7799

Other names 1

  • Katie Pounds Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
PTA5414MSMDPhysical Therapy Assistant
2000015468MSMDAthletic Trainer

Practice roles

OrganizationSpecialtyStatusNew patients
MSK Group, PC Physical Therapy Assistant Past Accepting new patients
Cornerstone Rehabilitation of Batesville Inc Past Accepting new patients

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1391558400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1793404800000",
    "number": "1124442579",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4515 POPLAR AVE STE 210",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "381177506",
            "telephone_number": "901-728-6912",
            "fax_number": "901-701-2428"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4515 POPLAR AVE STE 210",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "381177506",
            "telephone_number": "901-728-6912",
            "fax_number": "901-701-2428"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "109 Eureka St",
            "address_2": "Suite A",
            "address_purpose": "LOCATION",
            "city": "Batesville",
            "state": "MS",
            "postal_code": "386062534",
            "country_code": "US",
            "telephone_number": "662-578-7799",
            "fax_number": "662-578-7992",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CLARK",
        "first_name": "KATIE",
        "middle_name": "POUNDS",
        "credential": "PTA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-02-05",
        "last_updated": "2026-10-31",
        "certification_date": "2026-10-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "MS",
            "license": "PTA5414",
            "primary": true
        },
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "MS",
            "license": "2000015468",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KATIE",
            "last_name": "POUNDS",
            "credential": "PTA",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Memphis, TN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 31, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.